Depression is associated with various inflammatory-related physical conditions, such cardiovascular and neurodegenerative diseases. Yet, little is known about the association between depression and autoimmune diseases.

To examine the association between depression and risk of autoimmune disease, investigating the temporal and dose-response nature of these relationships.

A prospective study including approximately 1.1 million people is conducted using linked Danish registries. We have identified 145,217 participants with depression between 1995 and 2012. Survival analyses are used to estimate the relative risk of autoimmune disease among those with, compared to without, depression. Analyses are adjusted for covariates.

Preliminary analyses indicate an association between depression and an increased risk of several autoimmune diseases, with a potential dose-response correlation. Final results are still in progress.

Depression seems to be associated with increased risk of the onset of a range of autoimmune diseases. As such, depression may play a role in the etiology of certain autoimmune conditions.

The world-wide interest in bipolar disorder is illustrated by an exponential increase in annual publications on the disorder registered in Pubmed since 1990. This inspired an overview on the clinical development.

To assess bipolar disorder in a coherent timeframe to identify changing patterns in incidence and mortality.

To investigate secular trends in incidence of bipolar disorder in psychiatric care, examine the time lapse from first affective diagnosis to diagnosis of bipolar disorder and determine mortality and causes of death.

First-ever diagnoses of bipolar disorder (ICD-10 code F31) between 1995 and 2012 were identified in the nationwide Danish Psychiatric Central Research Register. Prior affective disorders were found as well. Causes of death were obtained from The Danish Register of Causes of Death.Age- and gender standardized incidence rates and standardized mortality ratio were calculated.

A total of 15,334 incident cases of bipolar disorder were identified. The incidence rate increased from 18.5/100,000 person-years (PY) in 1995 to 28.4/100,000 PY in 2012. The age group with the highest incidence decreased from 60-79 years to 20-39 years. The mean time from first affective diagnosis to diagnosis of bipolar disorder was 7.9 years (SD=9.1). The standardized mortality ratio was 1.7 (95%-CI=1.2-2.1). Causes of death were mainly natural, but 9% died from suicide.

The incidence of bipolar disorder increased significantly over a timeframe of 17 years mortality was higher compared to the general population. Treatment to lower mortality needs focus on both natural and unnatural causes.

Borderline personality disorder (BPD) is a complex mental disorder of instability in affect regulation, impulse control, interpersonal relationships and self-image. Comorbidity is common both within other personality disorders and other psychiatric disorders.

The Danish Psychiatric Central Research Register (DPCRR) is nationwide and makes it possible to follow psychiatric patients over long periods. Thus the DPCRR can bring in new understandings of comorbidity in BPD patients and their former and future morbidity.

To determine the psychiatric comorbidity profile of Danish psychiatric inpatients diagnosed with BPD from 1970 through 2012, and analyse the diagnostic profile before and after the first diagnosis of BPD.

All first time-ever diagnoses of BPD among psychiatric inpatients were identified in the DPCRR from 1970 through 2012. Information of their previous and future admissions were grouped in accordance with ICD-10.

A total of 23,221 persons diagnosed with BPD was identified in the DPCRR between 1970 and 2012, 73.1% female.

The must prevalent co-occuring diagnosis is substance abuse present in 12% of the patients. Depressive disorders are present in 23% of previous admissions, 27% of future and co-occur for 9%. Bipolar disorders are present in 2% of previous admissions, 7% of future and cooccur for less than 1%. PTSD and ADHD co-occur and are present in previous and future admissions for less than 5%.

In progress.

Delirium is an acute disorder of attention and cognition with a fluctuating course caused by physiological abnormalities. The syndrome is common, serious, under-recognised, and can be fatal.

There are very few studies concerning mortality of delirious patients in psychiatric departments, just as there is a lack of literature on delirium in psychiatric patients in general.

To determine the psychiatric co-morbidity profile of Danish psychiatric inpatients diagnosed with delirium, and to analyse the standardized mortality rate ratio and predictors of mortality in the same patients from 1995 through 2012.

All first time-ever diagnoses of delirium among psychiatric inpatients were identified in the nationwide Danish Psychiatric Central Research Register (DPCRR) from 1995 through 2012. The delirium diagnoses include 1) delirium unspecified, 2) delirium in dementia, and 3) delirium drugrelated, all in accordance with ICD-10. The mortality rates were age-standardized and the statistical analyses performed with STATA 12.

A total of 7,246 persons diagnosed with delirium was identified in the DPCRR between 1995 and 2012.

Dementia was present in 7% before a diagnosis of unspecified delirium, and about one sixth was diagnosed with dementia after the episode of delirium. A dementia-diagnose before, co-occurring, and after delirium in dementia was seen in 39.8%, 61.9%, and 54.5% respectively.

Drug-related delirium co-occurred most often with another substance-use related disorder. Sedatives or hypnotics cover the majority of substance use at the time of drug-related delirium.

Further analyses are presently in progress.

In progress.

The incidence of different psychiatric diagnoses in Danish Psychiatric Hospitals are characterized by fluctuations. This phonemena could be due to changes in true incidence, changes in the entry into the health care system, changes in the diagnostic practices and the possibilities of treatment for a given disease, or due to changes in the attention towards the disease within the population, the profesionals or the medias.

Nowadays there is a notable increase of the number of new ADHD diagnoses among children and adults.

There is a need for epidemiological measures in ADHD in The Danish Psychiatric Health Care System.

To investige treated incidence in ADHD in adults in Denmark through the period of 1995–2012, and to investigate psychiatric comorbidity, latency from the first contact to the ADHD diagnosis and mortality.

From The Danish Psychiatric Central Research Register all patients with following diagnoses given for the first time ever after their 18th birthday were identified: ICD-10: F.90.0, F90.1, F90.8, F90.9, F98.8.

These data are used to make an age standardized incidence rate throughout the period differentiated with gender and possible existence of previous childhood psychiatric diagnosis. We will also analyze for psychiatric comorbidity after their primary ADHD diagnosis.

The statistical analysis are still in progress.

There is a marked increase in treated incidence in adult ADHD from the introduction of ICD-10 to 2012. Further results about psychiatric comorbidity and mortality will be presented.

Electroconvulsive therapy (ECT) effectively treats severe depression, but not all patients remit. The aim of the study was to identify clinical factors that associate with ECT-induced remission in a community setting.

Depressed patients who underwent ECT in 2011–2014 were identified from the Swedish National Quality Register for ECT. Remission was defined as self-rated Montgomery-Åsberg Depression Rating Scale scores of 0–10 after ECT. Other registers provided data on previous antidepressant use, comorbidities, and demographics.

Of 1671 patients fulfilling the inclusion criteria, 42.8% achieved remission. Older age, education length over 9 years, psychotic symptoms, shorter duration of preceding antidepressant use, pulse width stimulus ≥ 0.50 ms, absence of substance use disorders, anxiety diagnosis, lamotrigine, and benzodiazepines, were associated with remission.

This study shows that psychotic subtype of depression and older age are clinically relevant predictors of a beneficial ECT effect. Additionally, ECT outcomes can be further improved by optimizing the treatment technique and concomitant medication.

The last two decades increase in early detection and diagnosing children with autism spectrum disorders (ASD) has challenged child and youth habilitation centers to offer the best and most appropriate treatment and support.

To evaluate an ongoing Comprehensive Intensive Early Intervention (CIEI) program for children with ASD based on principles of behaviour learning and developmental science, implemented in the child's natural setting.

The change in autism symptoms among children participating in CIEI (intervention group, n = 67) was compared with children who received traditional habilitation services only (comparison group, n = 27). Symptom changes were measured as evaluation-ADOS-R-scores, total-, severity-, and module-adjusted-scores (ADOS-MAS), minus the corresponding baseline-scores, divided by the time between baseline and evaluation, and estimated using ANOVA adjusting for confounders. The ADOS-MAS were developed to allow improved communicative functions to be counted in the overall symptom improvement.

Children in both study groups improved their autism symptoms as measured with the ADOS-MAS, and the improvement was statistically significantly larger among children without any developmental delay (P < .001). When adjustments were made for developmental delay, there was a statistically significant larger improvement of ADOS-MAS among children in the intervention group than in the comparison group (P = 0.047). Similar results were found for ADOS-R-total and ADOS-severity scores (P = 0.023 and P = 0.060. respectively).

The results of the current study indicate that the CIEI program significantly improve social and communicative skills among children with autism, and that children with developmental delay could benefit to a similar degree as other children.

The authors have not supplied their declaration of competing interest.

To document patient characteristics and treatment patterns in a real-world population diagnosed with attention-deficit/hyperactivity disorder (ADHD).

This was a retrospective chart review of children/adolescents (6–17 years) diagnosed with ADHD in the UK, Germany and Netherlands who initiated stimulant monotherapy (SM), non-stimulant (atomoxetine) monotherapy (NSM) or polypharmacy (SM/NSM ± SM/NSM or other psychotropics) on/after 1-1-2012. To facilitate descriptive comparisons, cohort quotas were imposed: ∼50% SM; ∼25% NSM; ∼25% polypharmacy. Index date was first SM, NSM or polypharmacy treatment on/after 1-1-2012. Patients were required to have ≥ 6 months’ pre-index (baseline) history and ≥ 12 months’ post-index follow-up. Analyses were descriptive.

In total, 497 patients were included (mean [SD] age: 10.8 [2.9] years; 77% male); 65% (SM), 63% (NSM) and 83% (polypharmacy) had at least marked baseline ADHD severity based on Clinical Global Impressions scale (P < 0.05 SM/NSM vs polypharmacy). Ninety percent (SM), 75% (NSM) and 73% (polypharmacy) were pharmacotherapy naïve at index (all P < 0.10); 61% (SM), 65% (NSM) and 72% (polypharmacy) received previous behavioural therapy. In SM patients, methylphenidate was predominant (most frequent brands: Concerta® [29%], Medikinet® [28%]); in polypharmacy patients, methylphenidate plus atomoxetine (22%) or other psychotropic (19%) was most common. Index therapy switch was common, particularly in polypharmacy patients (25%) (P < 0.05 vs SM [14%] and NSM [13%]). Switches were precipitated by poor response in 75% of cases overall.

Polypharmacy patients generally presented a more complicated history (including higher ADHD severity) and treatment pathway versus monotherapy patients. Index therapy switches were commonplace and more frequent in polypharmacy patients, often due to poor response.

The authors have not supplied their declaration of competing interest.

Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.

Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.

Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?

Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.